| NPI | 1336535830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE WATLINGTON Owner 336-254-9662 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-1110) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |